Document Detail


Late adverse events in coiled ruptured aneurysms with incomplete occlusion at 6-month angiographic follow-up.
MedLine Citation:
PMID:  19833795     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Patients with coiled ruptured aneurysms with incomplete occlusion at 6 months are not only at risk for rebleed during further follow-up but also for complications of angiographic follow-up and retreatment, and for progressive mass effect by uncontrollable aneurysm growth. We assessed the frequency and outcome of all these possible aneurysm-related events in 124 patients with incompletely occluded aneurysms at 6 months during a follow-up of 419 patient-years. MATERIALS AND METHODS: Between 1994 and 2007, 901 ruptured aneurysms were coiled and 713 (79%) had 6-month angiographic follow-up, of which 124 were incompletely occluded (17%). These 124 patients were followed for a mean of 41 months (median, 30 months; range, 1-150 months). RESULTS: During follow-up, 307 angiograms were obtained without complications. Of 124 aneurysms, 88 were retreated (71%). Fifteen aneurysms were retreated more than once. Altogether, 124 additional treatments were performed, and no complications occurred (0%; 95% CI, 0.0-3.6%). Four aneurysms rebled, causing death in 2 patients. Another 4 patients experienced progressive mass effect by growth of the coiled aneurysm, leading to death in 1. The annual event rate was 1.9%, the annual mortality was 0.7%, and the annual rebleed rate was 1.0% (8, 3, and 4 in 419 patient-years). CONCLUSIONS: In this study of patients with coiled ruptured aneurysms with incomplete occlusion at 6 months, a strategy of imaging follow-up and retreatment when possible leads to a low incidence of serious adverse events. Rebleeding and progressive mass effect of the aneurysm were responsible for these events, not complications from additional treatment or angiographic follow-up.
Authors:
S P Ferns; C B L M Majoie; M Sluzewski; W J van Rooij
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-15
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  31     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-16     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  464-9     Citation Subset:  IM    
Affiliation:
Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands. S.P.Ferns@amc.uva.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aneurysm, Ruptured / mortality*,  radiography,  therapy*
Cerebral Angiography
Cerebral Hemorrhage / mortality,  radiography
Disease Progression
Embolization, Therapeutic / adverse effects*,  mortality*
Female
Follow-Up Studies
Humans
Incidence
Intracranial Aneurysm / mortality*,  radiography,  therapy*
Male
Middle Aged
Retreatment / statistics & numerical data
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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